Drug Data Generic Name Ampicillin Pharmacologic Class: Penicillin Therapeutic Class: Antibiotic Dosage: 260 mg ANST

Mechanism of Action Bactericidal action against sensitive organisms; inhibits synthesis of bacterial cell wall, causing cell death. Pharmacokinetics D: Crosses placenta; enters breast milk M: Not known E: Urine, unchanged Drug Half Life 1-2 hours

Indication Treatment for acute gastroenteritis cause by bacteria.

Contraindications Concentrations - Allergies to penicillins, cephalosporins, or other allergens Precaution - Renal disorders Drug interaction Drug to drug - Increased ampicillin effect with probenecid - Increased risk of rash with allopurinol - Increased bleeding effect with heparin, oral anticoagulants - Decreased effect with tetracyclines, chloramphenicol - Decreased efficacy of hormonal contraceptives, atenolol with ampicillin Drug to food - Oral ampicillin may be less effective with food; take on empty stomach Drug to lab test - False-positive Coombs' test if given IV - Decrease in plasma estrogen concentrations in pregnant women - False-positive urine glucose tests if Clinitest, Benedict's solution or Fehling's solution is used

Adverse Reaction CNS: Lethargy, hallucinations, seizures CV: Heart failure GI: Glossitis, stomatitis, gastritis, sore mouth, furry tongue, black hairy tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomembranous colitis, nonspecific hepatitis GU: Nephritis Hematologic: Anemia, thrombocytopenia, leukopenia, neutropenia, prolonged bleednig time Hypersensitivity: Rash, fever, wheezing, anaphylaxis Local: Pain, phlebitis, thrombosis at injection site Other: Superinfections oral and rectal moniliasis, vaginitis

Nursing Intervention Before - Observe 15 rights in drug administration. - Assess for allergies to penicillins, cephalosporins, or other allergens. - Assess for renal disorders or lactation. - Culture infected area before treatment. - If patient is a woman and she uses hormonal contraceptive, she should use a second form of birth control for 1-2 weeks while taking this drug. During - Administer oral drug on an empty stomach, 1 hour before or 2 hours after meals. - Administer with a full glass of water. Do not give with fruit juice or soft drinks. - Do not give IM injections in the same site; atrophy can occur. - For IV administration, give slowly over 3-5 mins. - Use within 1 hour after preparation because potency may decrease significantly after that. After - Dispose of used materials properly. - Educate patient about side effects. - Instruct to report pain or discomfort at sites, unusual bleeding or bruising, mouth sores, rash, hives, fever, itching severe diarrhea, difficulty breathing. - Instruct patient not to use antibiotic to self-treat other infections. - Instruct to take the full course of drug therapy. - Do proper documentation.

Drug Data Generic Name Hydrocortisone Pharmacologic Class: Adrenal cortical steroid Corticosteroid Glucocorticostero id Therapeutic Class: Hormone Dosage 40 mg ANST

Mechanism of Action Enters target cells and binds to cytoplasmic receptor; initiates many complex reactions that are responsible for its anti-inflammatory, immunosuppressive (glucocorticoid), and salt-retaining (mineralocorticoid) actions.

Indication Treatment for gastrointestinal disorders like acute gastroenteritis. This help reduces cell damage and inflammation. It is also used to suppress the immune system; and aid in fat, protein and carbohydrate metabolism.

Contraindications Concentrations - Allergy to any component of the drug - Fungal infections - Amebiasis - Hepatitis B - Vaccinia or varicella - Antibiotic-resistant infections - Immunosuppression Precaution - Kidney disease - Liver disease - Cirrhosis - Hypothyroidism - Ulcerative colitis with impending perforation - Diverticulitis - Recent GI surgery - Active or latent peptic ulcer - Inflammatory bowel disease - Hypertension - Heart failure - Thromboembolic tendencies - Osteoporosis - Convulsive disorders - Metastatic carcinoma - Diabetes mellitus - TB - Lactation

Adverse Reaction CNS: Vertigo, headache, paresthesias, insomnia, seizures, psychosis CV: Hypotension, shock, HPN and heart failure secondary to fluid retention, thromboembolism, thrombophlebitis, fat embolism, cardiac arrhythmias Dermatologic: Thin, fragile skin, petechiae, ecchymoses, purpura, striae, subcutaneous fat atrophy EENT: Cataracts, glaucoma, increased IOP Endocrine: Amenorrhea, irregular mens, growth retardation, decreased carbohydrate tolerance and DM, cushingoid state, HPA suppression systemic , hyperglycemia GI: Peptic or esophageal ulcer, pancreatitis, abdominal distention, nausea, vomiting, increased appetite and weight gain Hematologic: Na and fluid retention, hypocalcemia, increased blood sugar, increased serum cholesterol, decreased T3 and T4 levels Hypersensitivity: Anaphylactoid or hypersensitivity reactions Musculoskeletal: Muscle weakness, steroid myopathy and loss of muscle mass, osteoporosis, spontaneous fractures Other: Immunosuppression, aggravation or masking of infections, impaired wound healing

Nursing Intervention Before - Assess for contraindications. - Assess body weight, skin color, V/S, urinalysis, serum electrolytes, X-rays, CBC. - Arrange for increased dosage when patient is subject to unusual stress. - Do not give live vaccines with immunosuppressive doses of hydrocortisone. - Observe the 15 rights of drug administration. During - Give daily before 9am to mimic normal peak diurnal corticosteroid levels. - Space multiple doses evenly throughout the day. - Use minimal doses for minimal duration to minimize adverse effects. - Do not give IM injections if patient has thrombocytopenic purpura. - Taper doses when discontinuing highdose or long-term therapy. After - Monitor client for at least 30 minutes. - Educate client on the side effects of the medication and what to expect. - Instruct client to report pain at injection site. - Instruct client to take drug exactly as prescribed. - Dispose of used materials properly. - Document that drug has been given.